APPLICATION By submitting this application, you acknowledge that you have the approval of your supervisor (if applicable). Project Name Total Funding Requested Name of Lead Unit Name of Key Partner Student Services Unit & Director (For approval) (If applicant is not a Student Services unit) By choosing a sponsoring service(s), you acknowledge that you have the approval of the service(s)'s Director(s), as expenses related to the project are administered through the Service. Project Lead Contact Information Last Name: First Name: E-mail: Phone: Has this project been submitted in ☐ Yes previous years? ☐ No Has this project proposal been submitted to any other grant competitions or other funding sources? Have other project proposals been submitted by your Service? What is the project timeline? Services Fund Account or Activity Code If yes, please specify when: ☐ Yes ☐ No If yes, please specify which: ☐ Yes ☐ No If yes, please list projects according to the priority you’d like them considered: 1. Click here to enter a date. to Click here to enter a date. Please answer the following questions in as concise a manner as possible Project Summary: Provide a brief background, describing the project and the inspiration behind it Project Eligibility: How will the project contribute to promoting and supporting student success and wellbeing? Project Outcomes and Deliverables: Identify the intended key outcomes and/or deliverables Project Collaborators and Stakeholders: List the key participants, stakeholders, and collaborators for this project and explain their roles Other than the project team, who will have a stake in your project? Please list the other individuals, groups or departments affiliated or affected directly or indirectly with your project In what capacity will they be involved? How they will be contributing to the project, i.e. immediate funding, future/ongoing funding, technical expertise, in-kind donations, etc. Letters of commitment may be attached Who will be otherwise affected by the project? Have they been consulted? Letters of support may be attached Describe any student involvement in developing the proposal and how students may be involved in designing, implementing and evaluating the initiative Alignment with Strategic Plan and/or mission: Describe how this innovation will support the goals articulated within the Student Services Strategic Plan as well as the individual Student Services unit’s Strategic Plan. Financials / Budget: Describe why you need this funding in order to implement your idea (i.e. that you do not have this funding already available already through other sources) Critical Date: Please state if there is a critical date by which funding is required (Please provide details of the budget using the budget template) Assessment: How will you assess whether the objectives have been met for this project? How will you measure the impact or value of this project’s outcomes? Sustainability: Specify how the initiative will be sustained after the period of initial funding, if that is the intention. The proposed new/enhanced activity should not depend on additional long-term budget support from the Student Services Innovation fund. Additional Information: Any other pertinent information may be appended (e.g., survey results, examples of similar projects, list of others sources of funding, etc.)